CN113939883A

CN113939883A - Digital biomarkers

Info

Publication number: CN113939883A
Application number: CN202080041689.6A
Authority: CN
Inventors: C·戈森斯; M·林德曼; F·利普斯梅尔; D·沃尔夫
Original assignee: F Hoffmann La Roche AG
Current assignee: F Hoffmann La Roche AG
Priority date: 2019-06-19
Filing date: 2020-06-17
Publication date: 2022-01-14
Also published as: EP3987537A1; JP2022537267A; WO2020254339A1; US20220104746A1

Abstract

Currently, assessing the severity and progression of symptoms in a subject diagnosed with muscle disability, particularly SMA, involves clinical monitoring and testing of the subject every 6 to 12 months. However, it is preferred to monitor and test subjects more frequently, but increasing the frequency of clinical monitoring and testing can be costly and inconvenient for the subject. Thus, assessing severity and progression of symptoms via remote monitoring and testing of the subject outside of a clinical setting, as described herein, provides advantages in terms of cost, ease of monitoring, and convenience to the subject. Systems, methods, and devices according to the present disclosure provide a diagnosis for assessing motor function in a subject suffering from muscle disability, particularly SMA, by active testing of the subject.

Description

Digital biomarkers

Technical Field

The present invention relates to a medical device for improved subject testing and subject analysis. More specifically, aspects described herein provide diagnostic devices, systems, and methods for assessing the severity and progression of symptoms of muscle disability, particularly Spinal Muscular Atrophy (SMA), in a subject by active testing of the subject.

Background

Spinal Muscular Atrophy (SMA) is an autosomal recessive genetic disease, also known as proximal spinal muscular atrophy and 5q spinal muscular atrophy. It is a life-threatening neuromuscular disease with low incidence of disease, associated with loss of motor neurons and progressive muscle wasting.

SMA has become a health problem and is also a significant economic burden on hygiene systems. Since SMA is a clinically heterogeneous disease of the CNS, diagnostic tools are needed to reliably diagnose and identify the current disease state and progression of symptoms, which can facilitate accurate treatment.

There are several standardized methods and tests for measuring symptom severity and progression in subjects diagnosed with SMA. The test involves a physician measuring the ability of a subject to perform a physical function. These standardized tests can provide an assessment of a variety of symptoms, particularly motor function, and can help track changes in these symptoms over time. Thus, assessing the severity and progression of symptoms using standardized methods and tests can help guide treatment and therapy selection.

Currently, assessment of the severity and progression of symptoms in subjects diagnosed with muscle disability, in particular SMA, involves clinical monitoring and testing of the subject every 6 to 12 months (http:// www.motor-function-measure. org/user-s-manual. aspx, MFM-18, MFM _ D3). While more frequent monitoring and testing of subjects is desirable, increasing the frequency of clinical monitoring and testing can be costly and inconvenient for subjects.

Disclosure of Invention

The following presents a simplified summary of various aspects described herein. This summary is not an extensive overview and is not intended to identify key or critical elements or to delineate the scope of the claims. The following summary merely presents some concepts in a simplified form as an introductory prelude to the more detailed description provided below. Aspects described herein describe specialized medical devices for assessing the severity and progression of symptoms in a subject diagnosed with muscle disability, particularly SMA. Testing and monitoring can be performed remotely outside of the clinical setting, providing subjects with lower cost, higher frequency, and simplified ease and convenience, improving detection of progression of symptoms, which in turn leads to better treatment.

According to one aspect, the present disclosure relates to a diagnostic device for assessing muscle disability, in particular motor function of SMA, in a subject. The device comprises: at least one processor; one or more sensors associated with the device, such as motion sensors; and a memory storing computer readable instructions that, when executed by the at least one processor, cause the apparatus to receive a plurality of first sensor data via the one or more sensors associated with the apparatus, extract a first plurality of features associated with muscle disability, in particular distal motor function of SMA, of the subject from the received first sensor data, and determine a first assessment of muscle disability, in particular distal motor function of SMA, based on the extracted first plurality of features.

E1 a diagnostic device for assessing motor function in a subject suffering from muscle disability, particularly SMA, the device comprising:

at least one processor;

one or more sensors associated with the device; and

a memory storing computer-readable instructions that, when executed by the at least one processor, cause the apparatus to:

receiving a plurality of first sensor data via the one or more sensors associated with the apparatus;

extracting from the received first sensor data a first plurality of features associated with motor function of the subject suffering from muscle disability, in particular SMA; and

determining a first assessment of motor function of the subject based on the extracted first plurality of features.

E2 the apparatus of E1, wherein the computer readable instructions, when executed by the at least one processor, further cause the apparatus to:

prompting the subject to perform a diagnostic task of tapping monsters back into their nest as soon as possible over a period of 30 s;

receiving, via the one or more sensors associated with the device, a plurality of second sensor data in response to the subject performing the diagnostic task;

extracting a second plurality of features associated with motor function of the subject from the received second sensor data; and

determining a second assessment of motor function of the subject based on the extracted second plurality of features.

E3 the apparatus according to any one of E1-2, wherein the apparatus is a smartphone.

E4 the apparatus according to any one of E1-3, wherein the diagnostic task is associated with at least one of motor function tests.

E5 a computer-implemented method for assessing motor function in a subject suffering from muscle disability, particularly SMA, the method comprising:

receiving a plurality of first sensor data via one or more sensors associated with an apparatus;

a first assessment of motor function of the subject suffering from muscle disability, in particular SMA, is determined based on the extracted first plurality of features.

E6 the computer-implemented method of E5, further comprising:

prompting the subject to perform one or more diagnostic tasks;

receiving, via the one or more sensors, a plurality of second sensor data in response to the subject performing the one or more diagnostic tasks;

extracting a second plurality of features associated with motor function of the subject suffering from muscle disability, in particular SMA, from the received second sensor data; and

a second assessment of motor function of the subject suffering from muscle disability, in particular SMA, is determined based at least on the extracted second sensor data.

E7 the computer-implemented method of any one of E5-6, wherein the subject's motor function is assessed based on an active task, in particular the duration of tapping a monster back into its nest as soon as possible over a period of 30 s.

E8 the device of any one of E1-4 or the computer-implemented method of any one of claims 5-7, wherein the subject is a human.

E9 a non-transitory machine-readable storage medium comprising machine-readable instructions for causing a processor to perform a method for assessing motor function in a subject suffering from muscle disability, particularly SMA, the method comprising:

receiving a plurality of sensor data via one or more sensors associated with an apparatus;

extracting a plurality of features associated with motor function of a subject suffering from muscle disability, in particular SMA, from the received sensor data; and

an assessment of motor function of a subject suffering from muscle disability, particularly SMA, is determined based on the extracted plurality of features.

E9 a method of assessing muscle disability, particularly SMA, in a subject comprising the steps of:

determining a usage behavior parameter from a data set comprising usage data for a device according to any of E1-5 within a first predefined time window, wherein the device has been used by the subject; and

comparing the determined at least one usage behavior parameter with a reference, whereby a subject suffering from muscle disability, in particular SMA, will be evaluated.

E10A method for identifying a subject as a subject having muscle disability, particularly SMA, comprising

i) Scoring the subject according to a diagnostic task of knocking monsters back into their nest as quickly as possible over a period of 30 s;

ii) comparing the determined score with a reference, whereby muscle disability, in particular SMA, will be assessed.

E12 the method of E11, further comprising: administering to the subject a pharmaceutically active agent to reduce the likelihood of muscle disability, particularly SMA progression, particularly wherein the pharmaceutically active agent is suitable for treating SMA in the subject, particularly an m7 gppppx x Diphosphatase (DCPS) inhibitor, a surviving motoneuronin 1 modulator, an inhibitor of SMN2 expression, a SMN2 splicing modulator, an enhancer of SMN2 expression, a modulator of surviving motoneuronin 2 or an inhibitor of SMN-AS1 (long non-coding RNA derived from SMN 1), more particularly norcissen (nusines), apavowed-onsonneio (onavic), lispano (risdipalm) or branapum (branapum).

E13 combination of the methods according to E12, wherein the determined at least one parameter is superior compared to the reference parameter of the patient prior to the subject receiving treatment with the agent.

E14 the method of E12-13, wherein the subject is human.

E15 the method of E12-14, wherein the agent is lispro.

Drawings

A more complete understanding of the aspects and advantages thereof described herein may be acquired by referring to the following description taken in conjunction with the accompanying drawings, in which like reference numbers indicate like features, and wherein:

fig. 1 is an exemplary environment diagram according to an exemplary embodiment, wherein a diagnostic device for assessing muscle disability, in particular motor function of SMA, in a subject is provided.

Fig. 2 is a flow diagram of a method for assessing muscle disability, particularly motor function of SMA, in a subject based on active testing of the subject, according to an exemplary embodiment.

FIG. 3 illustrates one example of a network architecture and data processing apparatus that may be used to implement one or more illustrative aspects described herein.

FIG. 4 depicts an example illustrating a diagnostic application according to one or more illustrative aspects described herein.

Fig. 5 is a graph illustrating sensor characterization results according to example 1.

Detailed Description

In the following description of the various aspects, reference is made to the accompanying drawings that form a part hereof, and in which is shown by way of illustration various embodiments in which the aspects described herein may be practiced. It is to be understood that other aspects and/or embodiments may be utilized, and structural and functional modifications may be made, without departing from the scope of the described aspects and embodiments. The aspects described herein are capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. Rather, the phrases and terms used herein are to be given their broadest interpretation and meaning. The use of "including" and "comprising" and variations thereof is meant to encompass the items listed thereafter and equivalents thereof, as well as additional items and equivalents thereof. The use of the terms "mounted," "connected," "coupled," "positioned," "engaged" and similar terms is intended to encompass both direct and indirect mountings, connections, couplings, positionings, and engagements.

The systems, methods, and devices described herein provide diagnostics for assessing muscle disability, particularly motor function of SMA, in a subject. In some embodiments, the diagnosis may be provided to the subject as a software application installed on a mobile device, particularly a smartphone.

In some embodiments, the diagnosis obtains or receives sensor data from one or more sensors associated with the mobile device as the subject performs activities of daily living. In some embodiments, the sensor may be within a mobile device such as a smartphone or a wearable sensor such as a smartwatch. In some embodiments, sensor features associated with muscle disability, particularly symptoms of SMA, are extracted from the received or obtained sensor data. In some embodiments, an assessment of muscle disability, in particular symptom severity and progression of SMA, in a subject is determined based on the extracted sensor features.

In some embodiments, systems, methods, and devices according to the present disclosure provide a diagnostic for assessing muscle disability, particularly SMA, in a subject based on an active test of the subject. In some embodiments, the diagnosis prompts the subject to perform a diagnostic task. In some embodiments, the diagnostic task is anchored or modeled after the established methods and standardized tests. In some embodiments, the diagnosis obtains or receives sensor data via one or more sensors in response to the subject performing a diagnostic task. In some embodiments, the sensor may be within a mobile device or wearable sensor worn by the subject. In some embodiments, sensor features associated with muscle disability, in particular symptoms of SMA, are extracted from the received or obtained sensor data. In some embodiments, an assessment of muscle disability, in particular symptom severity and progression of SMA, in a subject is determined based on the extracted sensor data features.

Assessment of muscle disability, particularly symptom severity and progression of SMA, using a diagnosis according to the present disclosure is well-correlated with assessment based on clinical outcome, and thus can replace clinical subject monitoring and testing. Exemplary diagnostics according to the present disclosure can be used outside of a clinical setting, and thus have advantages in terms of cost, ease of subject monitoring, and convenience for the subject. This facilitates frequent, especially daily, monitoring and testing of subjects to better understand the stage of disease and provide insight into the disease, which is useful to both the clinical and research communities. Exemplary diagnostics according to the present disclosure may provide for earlier detection of muscle disability in a subject, particularly minor changes in motor function of SMA, and thus may be useful for better disease management including personalized therapy.

Fig. 1 is an exemplary environment diagram in which a diagnostic apparatus 105 for assessing muscle disability, particularly motor function of SMA, in a subject 110 is provided. In some embodiments, device 105 may be a smartphone, smart watch, or other mobile computing device. The device 105 includes a display screen 160. In some embodiments, the display screen 160 may be a touch screen. The apparatus 105 includes at least one processor 115 and a memory 125 storing computer instructions for a symptom monitoring application 130, which when executed by the at least one processor 115, cause the apparatus 105 to assess muscle disability, in particular, motor function of SMA. The device 105 receives a plurality of sensor data via one or more sensors associated with the device 105. In some embodiments, the one or more sensors associated with the apparatus are at least one of: a sensor disposed within the apparatus or a sensor worn by the subject and configured to communicate with the apparatus. In fig. 1, the sensors associated with the device 105 include a first sensor 120a disposed within the device 105 and a second sensor 120b wearable by the subject 110. As the subject 110 performs the activity, the apparatus 105 receives a plurality of first sensor data via the first sensor 120a and a plurality of second sensor data via the second sensor 120 b.

The apparatus 105 extracts features associated with muscle disability of the subject 110, in particular motor function of the SMA, from the received first sensor data and second sensor data. In some embodiments, the muscle disability of subject 110, particularly symptoms of SMA, may comprise symptoms indicative of distal motor function of subject 110, symptoms indicative of motor function of subject 110.

In some embodiments, the sensors 120 associated with the device 105 may include sensors associated with bluetooth and WiFi functionality, and the sensor data may include information associated with bluetooth and WiFi signals received by the sensors 120. In some embodiments, the device 105 extracts data from the received first and second sensor data corresponding to the density of bluetooth and WiFi signals received or transmitted by the device 105 or the sensors. In some embodiments, the assessment of motor function of subject 110 may be based on the extracted bluetooth and WiFi signal data (e.g., the assessment of the subject's social ability may be based in part on the density of the picked-up bluetooth and WiFi signals).

The apparatus 105 determines an assessment of muscle disability of the subject 110, in particular motor function of the SMA, based on the extracted features of the received first sensor data and second sensor data. In some embodiments, the device 105 sends the extracted features to the server 150 over the network 180. The server 150 comprises at least one processor 155 and a memory 161 storing computer instructions for a symptom assessment application 170, which when executed by the server processor 155, cause the processor 155 to determine an assessment of muscle disability, in particular, motor function of the SMA, of the subject 110 based on the extracted features received by the server 150 from the apparatus 105. In some embodiments, the symptom assessment application 170 may determine an assessment of muscle disability of the subject 110, particularly motor function of SMA, based on the extracted features of the sensor data received from the apparatus 105 and the subject database 175 stored in the memory 160. In some embodiments, subject database 175 may include subject and/or clinical data. In some embodiments, the subject database 175 may include clinical and sensor-based measurements of motor function from baseline and longitudinal of muscle disabilities, particularly SMA, of a subject. In some embodiments, subject database 175 may be independent of server 150. In some embodiments, the server 150 sends to the apparatus 105 a determined assessment of muscle disability of the subject 110, in particular motor function of SMA. In some embodiments, the apparatus 105 may output an assessment of muscle disability, particularly motor function of SMA. In some embodiments, the device 105 may communicate information to the subject 110 based on the assessment. In some embodiments, an assessment of muscle disability, particularly motor function of SMA, may be communicated to a clinician, who may determine a personalized therapy for subject 110 based on the assessment.

In some embodiments, the computer instructions of the symptom monitoring application 130, when executed by the at least one processor 115, cause the apparatus 105 to assess muscle disability of the subject 110, in particular motor function of the SMA, based on an active test of the subject 110. The device 105 prompts the subject 110 to perform one or more tasks. In some embodiments, prompting the subject to perform one or more diagnostic tasks includes prompting the subject to transcribe a pre-specified sentence or prompting the subject to perform one or more actions. In some embodiments, the diagnostic task is anchored or modeled after established methods and standardized tests for assessing and assessing muscle disability, particularly SMA.

In response to subject 110 performing one or more diagnostic tasks, diagnostic device 105 receives a plurality of sensor data via one or more sensors associated with device 105. As described above, the sensors associated with the device 105 may include a first sensor 120a disposed within the device 105 and a second sensor 120b worn by the subject 110. The device 105 receives a plurality of first sensor data via the first sensor 120a and a plurality of second sensor data via the second sensor 120 b. In some embodiments, the one or more diagnostic tasks may be associated with a measure of motor function, particularly a measure of the time to hit a monster.

The apparatus 105 extracts a feature associated with muscle disability of the subject 110, in particular motor function of the SMA, from the received plurality of first sensor data and the received plurality of second sensor data. The muscle disability of subject 110, particularly symptoms of SMA, can include symptoms indicative of motor function of subject 110.

The apparatus 105 determines an assessment of muscle disability of the subject 110, in particular motor function of the SMA, based on the extracted features of the received first sensor data and second sensor data. In some embodiments, the device 105 sends the extracted features to the server 150 over the network 180. The server 150 may include at least one processor 155 and memory 161 storing computer instructions for a symptom assessment application 170 that, when executed by the server processor 155, cause the processor 155 to determine an assessment of muscle disability of the subject 110, in particular, motor function of SMA, based on the extracted features received by the server 150 from the apparatus 105. In some embodiments, the symptom assessment application 170 may determine an assessment of muscle disability of the subject 110, particularly motor function of SMA, based on the extracted features of the sensor data received from the apparatus 105 and the subject database 175 stored in the memory 160. In some embodiments, subject database 175 may include subject and/or clinical data. In some embodiments, the subject database 175 may include measurements of motor function from baseline and longitudinal direction of muscle disability, particularly SMA, of the subject. In some embodiments, the subject database 175 may include data from subjects at other stages of muscle disability, particularly SMA. In some embodiments, subject database 175 may be independent of server 150. In some embodiments, the server 150 sends to the apparatus 105 a determined assessment of muscle disability of the subject 110, in particular motor function of SMA. In some embodiments, the apparatus 105 may output an assessment of muscle disability, particularly motor function of SMA. In some embodiments, the device 105 may communicate information to the subject 110 based on the assessment. In some embodiments, an assessment of muscle disability, particularly motor function of SMA, may be communicated to a clinician, who may determine a personalized therapy for subject 110 based on the assessment.

Fig. 2 illustrates an exemplary method for assessing muscle disability, particularly motor function of SMA, in a subject based on an active test of the subject using the exemplary apparatus 105 of fig. 1. While fig. 3 is described with reference to fig. 1, it should be noted that the method steps of fig. 3 may be performed by other systems. The method includes prompting the subject to perform one or more diagnostic tasks (205). The method includes receiving a plurality of sensor data via one or more sensors in response to a subject performing one or more tasks (step 210). The method includes extracting a plurality of features associated with muscle disability, in particular motor function of the SMA, from the received sensor data (215). The method comprises determining an assessment of muscle disability, in particular motor function of the SMA, based at least on the extracted sensor data (step 220).

Fig. 2 illustrates an exemplary method for assessing muscle disability, particularly motor function of SMA, based on active testing of a subject 110 using the exemplary apparatus 105 of fig. 1. In some embodiments, the active test performed by subject 110 using device 105 may be selected via a user interface of symptom monitoring application 130.

The method begins with step 205, which includes prompting the subject to perform one or more diagnostic tasks. Device 105 prompts subject 110 to perform one or more diagnostic tasks. In some embodiments, prompting the subject to perform one or more diagnostic tasks includes prompting to perform one or more actions. In some embodiments, the diagnostic task is anchored or modeled after established methods and standardized tests for assessing and assessing muscle disability, particularly SMA.

In some embodiments, the diagnostic task may include hitting monsters as frequently as possible within 30 seconds.

As used herein, the term "test" describes a test that requires a subject to perform a diagnostic task as described herein.

The method proceeds to step 210, which includes receiving, via the one or more sensors, a plurality of second sensor data in response to the subject performing the one or more diagnostic tasks. In response to subject 110 performing one or more diagnostic tasks, diagnostic device 105 receives a plurality of sensor data via one or more sensors associated with device 105. As described above, the sensors associated with the device 105 include a first sensor 120a disposed within the device 105 and a second sensor 120b worn by the subject 110. The device 105 receives a plurality of first sensor data via the first sensor 120a and a plurality of second sensor data via the second sensor 120 b.

The method proceeds to step 215, which includes extracting a second plurality of features associated with muscle disability, particularly motor function of the SMA, from the received sensor data. The apparatus 105 extracts features associated with muscle disability of the subject 110, in particular motor function of the SMA, from the received first sensor data and second sensor data. The muscle disability of subject 110, particularly symptoms of SMA, can include symptoms indicative of motor function of subject 110. In some embodiments, the extracted features of the plurality of first and second sensor data may be indicative of muscle disability, in particular a symptom of SMA, such as motor function.

The method proceeds to step 220, which includes determining an assessment of muscle disability, in particular motor function of the SMA, based at least on the extracted sensor data. The apparatus 105 determines an assessment of muscle disability of the subject 110, in particular motor function of the SMA, based on the extracted features of the received first sensor data and second sensor data. In some embodiments, the device 105 may send the extracted features to the server 150 over the network 180. The server 150 comprises at least one processor 155 and a memory 160 storing computer instructions for a symptom assessment application 170, which when executed by the processor 155, determines an assessment of muscle disability, in particular, motor function of the SMA, of the subject 110 based on the extracted features received by the server 150 from the apparatus 105. In some embodiments, the symptom assessment application 170 may determine an assessment of muscle disability of the subject 110, particularly motor function of SMA, based on the extracted features of the sensor data received from the apparatus 105 and the subject database 175 stored in the memory 160. Subject database 175 may include various clinical data. In some embodiments, the second device may be one or more wearable sensors. In some embodiments, the second device may be any device that includes a motion sensor having an Inertial Measurement Unit (IMU). In some embodiments, the second device may be several devices or sensors. In some embodiments, subject database 175 may be independent of server 150. In some embodiments, the server 150 sends to the apparatus 105 a determined assessment of muscle disability of the subject 110, in particular motor function of SMA. In some embodiments, such as in fig. 1, the apparatus 105 may output an assessment of muscle disability, particularly the motor function of the SMA, on a display 160 of the apparatus 105.

As described above, assessment of the severity and progression of muscle disability, particularly SMA, using a diagnosis according to the present disclosure is well-correlated with assessment based on clinical outcome, and thus can replace clinical subject monitoring and testing. The diagnosis according to the present disclosure was studied in a group of subjects suffering from muscle disability, in particular SMA subjects. The subject is provided with a smartphone application, which includes a motor function test, particularly a test named "hit monster".

Fig. 3 illustrates one example of a network architecture and data processing apparatus that may be used to implement one or more illustrative aspects described herein, such as the aspects described in fig. 1 and 2. The

various network nodes

303, 305, 307, and 309 may be interconnected via a Wide Area Network (WAN)301, such as the internet. Other networks may also or alternatively be used, including private intranets, corporate networks, LANs, wireless networks, personal networks (PANs), and the like. Network 301 is for illustration purposes and may be replaced with fewer or other computer networks. A Local Area Network (LAN) may have one or more of any known LAN topology and may use one or more of a number of different protocols, such as ethernet.

Devices

303, 305, 307, 309 and other devices (not shown) may be connected to one or more networks via twisted pair, coaxial cable, optical fiber, radio waves, or other communication media.

The term "network" as used herein and depicted in the figures refers not only to a system in which remote storage devices are coupled together via one or more communication paths, but also refers to a stand-alone device that may occasionally be coupled to a system having storage functionality. Thus, the term "network" includes not only "physical networks" but also "content networks" which are composed of data (due to a single entity) residing in all physical networks.

The components may include a data server 303, a web server 305, and

client computers

307, 309. The data server 303 provides overall access, control, and management of the database and control software for performing one or more illustrative aspects described herein. Data server 303 may be connected to a web server 305 through which users interact and obtain data upon request. Alternatively, the data server 303 itself may act as a web server and connect directly to the internet. Data server 303 may be connected to web server 305 through network 301 (e.g., the internet), via a direct or indirect connection, or via some other network. A user may interact with the data server 303 using remote computers 307, 309 (e.g., using a web browser) through one or more externally published websites hosted by the web server 305 to connect to the data server 303.

Client computers

307, 309 may be used with data server 303 to access data stored therein, or may be used for other purposes. For example, as is known in the art, a user may access web server 305 from client device 307 using an internet browser or by executing a software application that communicates with web server 305 and/or data server 303 over a computer network (such as the internet). In some embodiments, client computer 307 may be a smartphone, smart watch, or other mobile computing device, and may implement a diagnostic device, such as device 105 shown in fig. 1. In some embodiments, data server 303 may implement a server, such as server 150 shown in FIG. 1.

The server and application may be combined on the same physical computer and maintain separate virtual or logical addresses, or may reside on separate physical computers. Fig. 1 illustrates only one example of a network architecture that may be used, and those skilled in the art will appreciate that the particular network architecture and data processing apparatus used may vary and assist in the functionality that they provide, as described further herein. For example, the services provided by web server 305 and data server 303 may be combined on a single server.

Each

component

303, 305, 307, 309 may be any type of known computer, server, or data processing device. Data server 303 may include, for example, a processor 311 that controls the overall operation of rate server 303. The data server 303 may further include RAM 313, ROM 315, a network interface 317, input/output interfaces 319 (e.g., keyboard, mouse, display, printer, etc.), and memory 321. The I/O319 may include various interface units and drivers for reading, writing, displaying, and/or printing data or files. The memory 321 may further store operating system software 323 for controlling the overall operation of the data processing apparatus 303, control logic 325 for instructing the data server 303 to perform aspects described herein, and other application software 327 that provides auxiliary, support, and/or other functionality, which may or may not be used in conjunction with other aspects described herein. The control logic may also be referred to herein as data server software 325. The functionality of the data server software may refer to a combination of operations or decisions made automatically based on rules encoded into the control logic, operations made manually by a user providing input to the system, and/or automatic processing based on user input (e.g., queries, data updates, etc.).

The memory 321 may also store data for performing one or more aspects described herein, including a first database 329 and a second database 331. In some embodiments, the first database may comprise the second database (e.g., as a separate table, report, etc.). That is, depending on the system design, the information may be stored in a single database or may be separated into different logical, virtual, or physical databases.

Devices

305, 307, 309 may have a similar or different architecture as described with respect to device 303. Those skilled in the art will appreciate that the functionality of the data processing apparatus 303 (or the

apparatuses

305, 307, 309) as described herein may be distributed across a plurality of data processing apparatuses, for example, to distribute the processing load among a plurality of computers to separate processing according to geographic location, user access level, quality of service (QoS), and the like.

One or more aspects described herein can be embodied in computer-usable or readable data and/or computer-executable instructions, such as in one or more program modules, executed by one or more computers or other devices described herein. Generally, program modules include routines, programs, objects, components, data structures, etc. that perform particular tasks or implement particular abstract data types when executed by a processor in a computer or other device. A module may be written in a source code programming language and then compiled to execute the module, or may be written in a scripting language such as (but not limited to) HTML or XML. The computer executable instructions may be stored on a computer readable medium such as a hard disk, optical disk, removable storage media, solid state memory, RAM, etc. As will be appreciated by one skilled in the art, the functionality of the program modules may be combined or distributed as desired in various embodiments. Additionally, the functionality may be embodied in whole or in part in firmware or equivalent hardware, such as integrated circuits, Field Programmable Gate Arrays (FPGAs), and the like. Particular data structures may be used to more effectively implement one or more aspects, and such data structures are included within the scope of computer-executable instructions and computer-usable data described herein.

FIG. 4 depicts an example illustrating a diagnostic test according to one or more illustrative aspects described herein. The user needs to select "start" to start the task.

FIG. 5 is a graph illustrating sensor signature results from the "tap monster" diagnostic test according to example 1 depicted in FIGS. 3A-C. The sensor signature (median time to hit monster) results are consistent with the clinical anchor point (bypassing the CD edge without compensating motion) in both studies.

Although the subject matter has been described in language specific to structural features and/or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described above. Rather, the specific features and acts described above are disclosed as illustrative forms of implementing the claims.

Example 1

Characteristics of the analyzed patient cohort collected in two different studies.

i) OLEOS study (https:// clinicalterals. gov/ct2/show/NCT02628743)

Participants of the analysis: 20

Data analysis period: smartphone data between recent clinical visits (176 days)

	Mean value (SD)	Range
			Age (age)	12.4(4.1) [ years old]	8.0 to 22.0
Sex	9 women and 11 men

ii) JEWELLISHIH study

(https://clinicaltrials.gov/ct2/show/NCT03032172term＝BP39054)

Participants of the analysis: 19

	Mean value (SD)	Range
			Age (age)	23.2(17.2) [ years old]	6.0 to 60.0
Sex	6 females and 13 males

Using a computer to implement a test acquisition dataset to determine finger strength (test: tapping monster) from pressure measurements, a central motor function test

Covariates: MFM-18, 2: MFM _ D3

ICC: intra-class correlation coefficient, SD ═ standard deviation

A test for pressure measurement of finger strength by pressure measurement was implemented on a cell phone (iPhone). The patient should hit the monster with the index finger to return the monster to its nest. The handset should be placed on a table. The monster should be tapped as quickly as possible. The patient must select the preferred hand to use. The patient is required to play the game for 30 seconds with the goal of achieving maximum pressure for a single tap, a moderate time to tap a monster after it occurs, and a total number of monsters tapped over a 30 second period of time. The standard deviation of the maximum pressure, the median of the maximum pressure, the maximum pressure for a single tap, the median time to hit a monster after it occurs, and the total number of monster hits obtained within 30 seconds are determined. A true monster hit is a test-specified event. The data is transmitted and the monster hit timestamp is used to calculate the median time to hit the monster.

Fig. 5 shows the correlation of the clinical anchoring test with the results of the encouragement monster test (time to hit — 50%). Sensor characterization results were consistent with clinical anchors (finger-by-finger CD margins) in both studies.

Claims

1. A diagnostic device for assessing motor function in a subject suffering from muscle disability, particularly SMA, the device comprising:

at least one processor;

one or more sensors associated with the device; and

2. The apparatus of claim 1, wherein the computer readable instructions, when executed by the at least one processor, further cause the apparatus to:

3. The apparatus of any of claims 1-2, wherein the apparatus is a smartphone.

4. The apparatus of any of claims 1-3, wherein the diagnostic task is associated with at least one of motor functions.

5. A computer-implemented method for assessing motor function in a subject suffering from muscle disability, particularly SMA, the method comprising:

6. The computer-implemented method of claim 5, further comprising:

prompting the subject to perform one or more diagnostic tasks;

7. The computer-implemented method of any of claims 5-6, wherein the subject's motor function is assessed based on an active task, in particular the duration of knocking monsters back into their nest as soon as possible over a period of 30 s.

8. The apparatus of any one of claims 1-4 or the computer-implemented method of any one of claims 5-7, wherein the subject is a human.

9. A non-transitory machine-readable storage medium comprising machine-readable instructions for causing a processor to perform a method for assessing motor function in a subject suffering from muscle disability, particularly SMA, the method comprising:

10. A method of assessing muscle disability, particularly SMA, in a subject comprising the steps of:

determining a usage behavior parameter from a data set comprising usage data for the apparatus according to any one of claims 1-4 within a first predefined time window, wherein the apparatus has been used by the subject; and

11. A method of identifying a subject as a subject having muscle disability, particularly SMA, comprising

12. The method of claim 11, further comprising: administering to the subject a pharmaceutically active agent to reduce muscle disability, particularly the likelihood of SMA progression, particularly wherein the pharmaceutically active agent is suitable for treating SMA in the subject, particularly an m7 gppppx x Diphosphatase (DCPS) inhibitor, a surviving motoneuronin 1 modulator, an inhibitor of SMN2 expression, an SMN2 splice modulator, an enhancer of SMN2 expression, a surviving motoneuronin 2 modulator, or an inhibitor of SMN-AS1 (long non-coding RNA derived from SMN 1), more particularly norcinolone, aparavivo-ondansinonotum, lissplant or braapon.

13. The combination of methods of claim 12, wherein the determined at least one parameter is more optimal compared to a reference parameter of the patient prior to the subject receiving treatment with the agent.

14. The method of claims 12-13, wherein the subject is a human.

15. The method of claims 12-14, wherein the agent is rivastigmine.